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Updated: Jun 25, 2025
Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
Can left atrial diameter measured by computed tomography predict the presence and degree of left ventricular
Gae An Kim1, Ji Ung Na1, Dong Hyuk Shin1
1Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Computed tomography-measured left atrial diameter (CTLAD) can help predict left ventricular diastolic dysfunction (LVDD). A CTLAD of ≥4.5 cm reliably distinguishes severe LVDD when echocardiography is unavailable.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Left ventricular diastolic dysfunction (LVDD) is a significant clinical condition.
- Echocardiography is the standard for LVDD assessment, but may not always be accessible.
- Computed tomography (CT) is widely available and can provide anatomical measurements.
Purpose of the Study:
- To evaluate if computed tomography-measured left atrial diameter (CTLAD) can predict the presence and severity of LVDD.
- To establish diagnostic thresholds for CTLAD in identifying LVDD grades.
Main Methods:
- Retrospective cross-sectional study of 373 adult patients undergoing both chest CT and echocardiography within 24 hours.
- Receiver operating characteristic (ROC) curve analysis was used to assess CTLAD's diagnostic performance for LVDD.
- Patients were categorized by LVDD grade (1, 2, or ≥3).
Main Results:
- 192 patients (51.5%) had LVDD.
- Median CTLAD values increased with LVDD grade (4.1 cm for grade 1, 4.5 cm for grade 2, 4.9 cm for ≥grade 3).
- CTLAD showed moderate to strong predictive power for higher-grade LVDD (AUC 0.657 for ≥grade 2, 0.834 for ≥grade 3).
Conclusions:
- CTLAD ≥4.4 cm can serve as a reference for identifying LVDD grade ≥2.
- CTLAD ≥4.5 cm reliably distinguishes LVDD grade ≥3.
- CTLAD is a potentially valuable tool for predicting LVDD when echocardiography is not feasible.
Objective:
This study was conducted to determine whether the presence and degree of left ventricular diastolic dysfunction (LVDD) can be predicted by the simple computed tomography -measured left atrial diameter (CTLAD).
Methods:
Among adult patients who underwent both chest CT imaging and echocardiography in the emergency department from January 2020 to December 2021, a retrospective cross-sectional study enrolled patients in whom the time interval between the two tests was <24 hours. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic power of CTLAD for echocardiographic LVDD.
Results:
In a study involving 373 patients, 192 (51.5%) had LVDD. Among them, 122 (63.5%) had grade 1, 61 (31.8%) had grade 2, and nine (4.7%) had ≥grade 3. Median CTLAD values were 4.1 cm for grade 1, 4.5 cm for grade 2, and 4.9 cm for ≥grade 3. The area under the ROC curve value of CTLAD in distinguishing ≥grade 1, ≥grade 2 (optimal cutoff ≥4.4 cm), and ≥grade 3 (optimal cutoff ≥4.5 cm) were 0.588, 0.657 (sensitivity, 61.4%; specificity, 66.0%, positive predictive value, 29.5%; negative predictive value, 88.1%; odds ratio, 3.1), and 0.834 (sensitivity, 88.9%; specificity, 70.1%; positive predictive value, 6.8%; negative predictive value, 99.6%, odds ratio, 18.7), respectively.
Conclusion:
CTLAD ≥4.4 cm can be used as a rough reference value to distinguish LVDD of ≥grade 2, while CTLAD ≥4.5 cm can reliably distinguish LVDD of ≥grade 3. CTLAD might be a useful parameter for predicting LVDD in situations where echocardiography is not available.
